Pulse articles from March 2003

Pulse archives from March 2003

Winners get 3 times more than losers.(Brief Article)
March 3, 2003... Each GP will get as little as #57,000 or up to #154,000 as their global sum during the first year of the new contract, Pulse has learned. A single point on the quality framework will be worth anything from #14.25 to #38.50 per GP. The...

`I can't decide until I'm told my earnings'.(Brief Article)
March 3, 2003... Dr Barbara Rushton says her vote hangs in the balance as she still can't tell what she will be earning under the contract. `We haven't got a clue what we are going to earn,' said the GP in Liphook, Hampshire. `It's all cutting it very fine....

GPs wait for news on practice income.(Brief Article)
March 3, 2003... GPs attending contract roadshows will not know how the contract affects their income before they question negotiators, writes Susan McNulty. The GPC has pledged to mail practices the figure for their notional patient list - the basis for...

Most GPs will already net #7,500 with no extra work.(Brief Article)
March 3, 2003... Most practices are already doing enough to earn 300 of the 1,000 quality points under the new contract without a stroke of extra work, GP negotiators say. A 300-point score would amount to an average payment of #7,500 per GP in the first...

Opting in may split practices.(Brief Article)
March 3, 2003... Dr James Graham is predicting the new contract could spark partnership disputes over optional services. Dr Graham, who practises in Liverpool, said he and his three partners expected to reach agreement on whether to opt into enhanced...

Step-by-step points for clinical targets.(Brief Article)
March 3, 2003... GPs will be paid a proportion of quality cash for partial achievement of clinical indicator targets. The maximum number of points will be awarded for full achievement, but a linear proportion will be awarded for partial success starting...

Score-card to be kept under review.
March 3, 2003... The GPC and the Government will continually review the score-card used to calculate quality payments. The score-card (see below) was designed to be simple and transparent but negotiators admit it may need fine-tuning. The contract...

Points will become more lucrative as years pass.
March 3, 2003... The average GP will be able to earn a maxium quality payment of #26,250 in the first year of the scheme. But the amount up for grabs for a GP with an average notional list will soar to #42,000 the following year as the cash value of points...

GP consultation length crucial.(Brief Article)
March 3, 2003... GPs must provide 10-minute consultations in booked appointments to achieve 30 of the total 100 points for patient experience. GPs with an open surgery system must spend at least eight minutes face to face with a patient. Copyright: CMP...

Golden handcuff fees not included.(Brief Article)
March 3, 2003... Golden handcuff payments to keep older GPs in the profession may not be available from 2004, despite their inclusion in early versions of the contract. The BMA said the references to `new retention payments' were included in error. ...

Wait to drop out-of-hours annoys GP.(Brief Article)
March 3, 2003... Dr Beryl Duncan is disappointed she may have to wait until December 2004 to give up out-of-hours. But she praised negotiators for ensuring GPs would only lose an average of #6,000 a year by opting out. Dr Duncan, a GP in Terrington St...

#750m cost of backdated GP pensions sunk deal.
March 3, 2003... Ministers refused to give GPs an increase in pensions backdated to 1990 because it would have cost the Treasury #750 million, Pulse has learned. A backdated increase in the dynamisation factor was one of the GPC's key demands because it...

GP quality pay will improve CHD care.(Brief Article)
March 3, 2003... Dr John Pittard has welcomed the quality and outcomes framework as a huge incentive to improve care for major diseases. Dr Pittard, a member of the external reference group for the CHD national service framework, said the incentives offered...

Last-ditch fudge agreed on childhood vaccinations.
March 3, 2003... The GPC fought until `the last minute' to ensure GPs who fail to hit 90 per cent uptake for childhood vaccinations will not face financial penalties. Under a complex compromise thrashed out with the Government, all practices will be...

Flu vaccine payment will cover under-65s.(Brief Article)
March 3, 2003... GPs will receive a nationally agreed fee for the first time for vaccinating at-risk under-65s against influenza under the new contract. The flu vaccination fee had not been revealed as Pulse went to press. GP negotiators hinted that the...

Start pestering PCOs if you want to drop out-of-hours.(Brief Article)
March 3, 2003... The GPC has spelled out what GPs should do if they want an early exit from out-of-hours work under the new contract. GP negotiators said GPs should start putting pressure on PCOs `as soon as possible' if the contract was accepted. Practices...

GPs sceptical on allocations deal.(Brief Article)
March 3, 2003... Enforced patient allocations will eventually be cut to zero, the new contract claims. It states in a majority of cases there will be no need to progress beyond the first stage of a new three-stage application process to close GP lists. ...

Negotiators refuse to `sell' new contract.(Brief Article)
March 3, 2003... GPC negotiators will not publicly back the new contract after privately admitting disappointment with key parts of the deal. During forthcoming roadshows, negotiators will simply `explain' the document rather than `sell' it to the...

Singlehanded GPs denied funds for extra staff costs.
March 3, 2003... Singlehanded GPs could lose out under the new contract because the Government refused GPC demands for special funds to help small practices. GPC joint-deputy chair Dr Hamish Meldrum said negotiators had pushed for extra money to cover...

Ulster GPs are promised #45m.(Brief Article)
March 3, 2003... GPs in Northern Ireland have been guaranteed investment totalling #45 million over the next three years if they accept the new contract. Des Browne, Minister for Health, Social Services and Public Safety, pledged the money would be spent on...

Deprivation out, London weighting in.(Brief Article)
March 3, 2003... The new contract introduces a London weighting to take account of the extra cost of practising in the capital. The weighting will also replace deprivation payments paid to London GPs after academics drawing up the global sum chose to...

Temporary resident fee replaced.(Brief Article)
March 3, 2003... GPs will no longer receive an item-of-service fee for temporary residents under the new contract. Instead they will get an additional amount in their global sum payment calculated from the average number of temporary residents the practice...

Lawyer investigates `wealth of cases of alleged GP negligence'.
March 3, 2003... A solicitor gathering evidence against GPs for alleged negligent prescribing of benzodiazepines says she has a `wealth' of cases under investigation. The news came as the Home Office announced plans to allow nurses and pharmacists to...

Government backs safety of thiomersal vaccines.(Brief Article)
March 3, 2003... The Government has reiterated its advice over the safety of vaccines containing thiomersal after scrutinising results from two major trials. The studies, which looked at the safety of thiomersal-containing vaccines in more than 100,000...

Diabetes tsar to check GPs meet targets.(Brief Article)
March 3, 2003... The Government has appointed a diabetes tsar to push through improvements in patient care and ensure GPs and doctors meet national service framework targets. Dr Sue Roberts, consultant diabetologist at North Tyneside District General...

PMS GPs can earn 22% more than GMS.
March 3, 2003... PMS GPs can earn up to 22 per cent more than GMS colleagues in the two years after switching contracts, according to GP accountants. Practices are pocketing extra cash from Government PMS growth monies and by negotiating high baseline...

Practice trains staff to handle emergencies.(Brief Article)
March 3, 2003... Dr Stuart Ketchin's practice is training receptionists in resuscitation techniques and handling emergency situations. The initiative for practices in Doncaster, South Yorkshire, was launched after a receptionist at another surgery asked a...

`No need for GP's sicknote'.(Brief Article)
March 3, 2003... A pilot scheme using companies' occupational health and personnel departments to handle sickness certification is set to begin in April. Under the scheme, in Macclesfield, Cheshire, a major employer has agreed to stop demanding statutory...

Workload pressures send GP divorce rates rocketing.
March 3, 2003... Divorce rates among GPs have rocketed in the past year because of rising workload pressures, says a divorce lawyer. Birmingham-based Benussi and Co said 30 per cent of its caseload was made up of medical professionals, the highest...

GPs face cholesterol target of 4mmol/l in all CHD patients.(coronary heart disease)
March 3, 2003... GPs will have tough new cholesterol-lowering targets to meet under forthcoming national guidance on managing coronary heart disease. The Joint British Societies' guidelines, due later this year, will recommend using statins and dietary...

GPs back electronic transfer of data.(Brief Article)
March 3, 2003... GPs believe electronic transfer of prescribing data between practices and pharmacists will improve repeat prescribing and cut workload, new research has found. But they are worried patient confidentiality could be compromised by the scheme...

800 GPs to be called up if war is declared.(Brief Article)
March 3, 2003... Up to 800 GPs could be called up in the event of a war on Iraq, the BMA has warned. Ministers have told the association at least half of these reservists would be flown to the Gulf if war was declared. All reservists are members of the...

Telemonitoring improves survival in heart failure.(Brief Article)
March 3, 2003... Monitoring congestive heart failure patients using telemedicine equipment dramatically improves their chances of survival, new research reveals. The study by the University of Hull followed up 427 congestive heart failure patients from 20...

New 28-day repeat script plan `crazy'.(Brief Article)
March 3, 2003... The GPC has condemned as `crazy' attempts by PCTs to impose blanket 28- day repeat prescribing intervals on GPs. Several trusts have standardised prescribing intervals for all or most drugs after pressure from pharmacists, who argue it cuts...

Letter: Has out-of-hours really been thought through?(Letter to the Editor)
March 3, 2003... I agree with Dr Philip Rathbone whose letter was headlined `Massive out- of-hours opt-out would threaten GPs' future' (February 24). The potential for GPs to opt out of out-of-hours care for some #6,000 may have deleterious effects on the NHS...

EDITORIAL COMMENT: Allocations deal will rob GPs of right to say no.(Brief Article)(Editorial)
March 3, 2003... One issue is crystal clear in all the confusion caused by the piecemeal publication of the proposed new contract - GPC negotiators made no headway on the issue of forced allocations. In fact, matters are likely to get even worse than they are....

Letter: Housing note? - Just say No.(Letter to the Editor)
March 3, 2003... I refer to Dr Lucy Free's article `An unfair complaint and the stress it has caused' (Features, February 17) in which a patient complained because Dr Free didn't do enough to facilitate her being given her own accommodation. If I had seen...

Out-of-hours: how to cope as GPs opt out.
March 3, 2003... Dr Mike Dixon expects a stampede away from 24-hours responsibility - the question is, will PCOs be able to cope? It seems almost unbelievable that one year from now we shall all be able to opt out of 24-hour responsibility. Judging from...

How GPs can play a crucial role in helping to cut emergency admissions.
March 3, 2003... A total rethink of the GP's pivotal role in emergency care is needed, according to Sir George Alberti GPs have a pivotal role in emergency care in the future. They have had a pivotal role in the past: the difference is that, from now on,...

Should I opt for a salaried or for a conventional partnership?(Brief Article)
March 3, 2003... Q: I have been looking for my first principal post. It is clearly a buyer's market with a good selection of jobs. The partnership I like best is a PMS practice that owns its premises. It has offered me the job, with an option of either salaried...

Why a `green socks' clause in practice?(partnership agreements)(Brief Article)
March 3, 2003... Q: What is a `green socks clause'? Should we include one in our practice agreement? A: The main benefit of a partnership agreement is that it allows the practice to list the circumstances under which it can expel a partner without going...

Couple with violence issues now want IVF.(infertility treatments)
March 3, 2003... Case history Hazel Smith has only been to the surgery once - to check her ribs weren't broken. She admitted her husband had pushed her over, as he was angry that she was not keeping the house tidy. The notes say Hazel does not want...

Dog is GP's and patients' best friend.
March 3, 2003... Dr Antony Natt tells us how joining the Pets As Therapy scheme revived his morale The new millennium found me tired and demoralised. Over the preceding year, my fruitless attempts to find a partner contradicted the politicians' vehement...

Role of the GP in detecting child development problems.
March 3, 2003... GP Dr Stefan Cembrowicz asks consultant paediatrician Dr Matthew Ellis about the range of commonly seen difficulties How common are developmental problems in children and how are they usually picked up? There is a wide range of...

Making best use of the endocrine lab.
March 3, 2003... Consultant Dr Anthony Robinson outlines the more common endocrine conditions, and how GPs can best use the available tests to diagnose them effectively Endocrinological testing is easier if you know the question you are asking, know how to...

TOP TIPS: Ingrowing toenails.(Brief Article)
March 3, 2003... GP experts pass on the benefits of their knowledge 1 Ingrowing toenails (IGTNs) are commonly caused by the inappropriate trimming of nails, especially the sides of the nails, but tight shoes and even tight socks can also responsible. 2...

How to make informed consent work in practice.
March 3, 2003... Dr David Molyneux on what is needed for the most frequent ethical issue GPs face - informed consent Consent is possibly the most frequent ethical issue encountered in general practice. Almost everything we do or say to a patient could be...

How to ride the audit cycle with confidence.
March 3, 2003... SIMPLE AUDITS ARE OFTEN THE BEST Audit is something we will all have to be familiar with whichever branch of medicine we work in. It sounds infinitely dull but can be simple, informative and rewarding. The summative assessment audit is...

ANSWER BACK: Safe physiotherapy with osteoporosis.(Brief Article)
March 3, 2003... Q: What physiotherapy is safe for an osteoporotic patient? How soon can a patient return to high-impact sport after two years of etidronate (Didronel) therapy? A: Regular weight-bearing exercise is important for the prevention and...

ANSWER BACK: How do I treat case of xanthelasmata?(Brief Article)
March 3, 2003... Q: A patient with marked xanthelasmata is considering having them removed surgically; those on her lower eyelid will have to remain as she is at risk of ectropion. Is there any evidence that lowering her cholesterol could cause these to...

12% pay rise for Yes vote - but 2.5% for No.
March 10, 2003... Every GP will see their pay leap by at least 12 per cent from April if they vote Yes to the contract, the GPC has promised. And in their strongest appeal yet for a Yes vote, negotiators warned that ministers will give GPs a pay rise of just...

#100m boost will favour GP co-ops.(Brief Article)
March 10, 2003... The Government has given primary care organisations an extra #100 million to provide out-of-hours services under the new contract. Much of the cash, to be spread over three years, is expected to go to co-operatives rather than NHS Direct in...

`Small practices will be penalised'.(Brief Article)
March 10, 2003... Dr Dearbhla Harley is worried about the effect of the new contract on small practices. Dr Harley, a GP in a two-partner practice in Portstewart, County Londonderry, is `quite positive' about the contract overall. But she is upset the...

Milburn promises GPs earned autonomy.(Alan Milburn)(Brief Article)
March 10, 2003... Health Secretary Alan Milburn has promised to reward high-achieving practices with freedom from their primary care organisations. In a speech that billed the new contract as a `once-in-a-lifetime' opportunity to shift the balance of the NHS...

Patients may suffer as GPs put focus on quality data.
March 10, 2003... The GPC has expressed concern that patients could suffer as GPs skew consultations around data collection for the quality framework of the new contract. Practices should use preparation and aspiration payments to hire data clerks and...

PMS GPs in limbo over quality cash.(primary medical services)(Brief Article)
March 10, 2003... GPs working in PMS remain in limbo over the contract just weeks before the ballot. The Government still has no idea how PMS practices will tap into the quality cash fund, but the GPC has urged PMS GPs to vote and then `sit on the fence'...

Extra cash revealed for new patients and nursing homes.(Brief Article)
March 10, 2003... GPs would be paid 43 per cent extra for patients in nursing homes and 46 per cent more for patients who have been on their list for less than a year under the new contract. Practices are also expected to spend just under half their global...

When will GPs be able to work out income?(Brief Article)
March 10, 2003... GLOBAL SUM Practices mailed notional list size - this week. Online ready-reckoner on BMA website for practices to factor in nursing home patients and list turnover - before ballot. QUALITY PAY #3,000 per GP next year for practices...

Contract could leave GPs trapped in bad partnerships.(Brief Article)
March 10, 2003... GPs in unhappy partnerships could be left `high and dry' by the new contract as partners clash over the enhanced services their practice should provide, partnership experts warn. Primary care organisations will no longer have to fund GPs...

PCOs urged not to `crawl over' GP data.(primary care organizations)(Brief Article)
March 10, 2003... The NHS Confederation has pleaded with primary care organisations not to `crawl all over' GPs when checking their performance under the new contract, writes Nerys Hairon. The call came as GPs expressed grave doubts about promised cuts in...

GPs with refugees lose out.(Brief Article)
March 10, 2003... Dr Clare Highton is worried her practice will lose out under the new contract because of the high number of asylum seekers and refugees on its list. The formula for calculating GPs' global sum uses census data which does not include the...

Ghost patients fear.(Brief Article)
March 10, 2003... The GPC has expressed concern at the implications of a planned change to the system for adjusting GP lists for `ghost' patients. Fees and allowances are currently scaled back nationally by 6 per cent to take account of list inflation, based...

`No vote will mean NHS armageddon'.(National Health Service)(Brief Article)
March 10, 2003... GPs could be voting for `armageddon' if they reject the new contract, GPC negotiator Dr Laurence Buckman has told GPs in Northern Ireland. Dr Buckman said they should think seriously about whether they will have to leave the NHS if they...

GPs brand LMC roadshows `futile' without pay details.
March 10, 2003... GPs gave GPC negotiators a rough ride in the first round of contract roadshows over the delay in giving them crucial pricing information. After the first meeting in Bolton, GPs told Pulse the event had been futile because they did not know...

Choice is yours, GPC says.(Brief Article)
March 10, 2003... Dr Simon Fradd, GPC joint-deputy chair, said there are three reasons why the negotiators are not commending the contract to the profession. At a meeting organised by west Kent GPs, Dr Fradd said the consultants committee had commended...

`PCOs will have to find cash for GP enhanced services'.(Brief Article)
March 10, 2003... The GPC has warned primary care organisations they would have to find money in their budgets for enhanced services in the contract. Negotiators spoke out last week after hearing from GPs of how their PCOs had told them they had already...

Contract alternatives up GPC sleeve.(Brief Article)
March 10, 2003... The GPC drew up a presentation on alternatives to the new contract in the final days of negotiations because it feared Government interference in the deal could make it miss the deadline. Dr Andrew Dearden, chair of GPC Wales, told GPs at...

GPs predict mass branch surgery closures.(Brief Article)
March 10, 2003... The new contract would bring about a mass closure of branch surgeries because of its demands on premises standards, GPs have predicted. Branch surgeries would have to meet the same criteria as main sites, including compliance with...

Pilot gives boost to allocations system.(Brief Article)
March 10, 2003... A pilot scheme based on the allocations system proposed in the contract has improved handling of the problem, according to GPs involved. Under the pilot in Hull and north east Lincolnshire, GPs, the LMC and PCT consult before allocations...

Subcontract.
March 10, 2003... GPs who want to give up additional services should subcontract them to another provider rather than opt out, the GPC has advised. The move would mean GPs would keep their status as a preferred provider of the service and could take the work...

Deal may not close pay gap for GPs in Scotland.(Brief Article)
March 10, 2003... The #10,000 pay gap between GPs in Scotland and England could remain under the new contract, the Scottish GPC says. GPC Scotland joint-chair Dr Mary Church said the morbidity levels and rurality of many practices in the country would not...

GP's rare doctorate.(Brief Article)
March 10, 2003... Dr Nick Summerton is one of only a handful of GPs to gain a doctorate in primary care medicine from the University of Oxford. Dr Summerton, a GP in Winterton, Lincolnshire, spent six years researching GP diagnosis of cancer, CHD and carpal...

Anti-fraud crackdown on GPs who use FP10s to stock treatment rooms.
March 10, 2003... The Government is cracking down on GPs who misuse prescription forms to stock their treatment rooms as part of its high-profile drive to cut fraud in the health service. The NHS Counter-Fraud Directorate is taking over the monitoring and...

New deadline for GPs to set up heart risk registers.(Brief Article)
March 10, 2003... The Government has given GPs until March 2006 to set up practice-based registers of patients at high risk of heart disease under the national service framework. The registers must include patients with a cardiac event risk greater than 30...

Mothers and children benefit from nurse care.(Brief Article)
March 10, 2003... Dr Vicky Pleydell says her practice has reaped great rewards from working with nurse prescribers because its patient list is dominated by young mothers and children. Dr Pleydell, chair of Hambleton and Richmondshire PCT professional...

Anger as nurses set to prescribe NSAID.(non-steroidal anti-inflammatory drugs)
March 10, 2003... Nurses will be able to prescribe non-steroidal anti-inflammatory drugs under Government plans to extend nurse prescribing. Pulse can reveal a consultation document from the Committee on Safety of Medicines, to be published soon, will...

GPs `will struggle on diabetes targets'.
March 10, 2003... GPs face an uphill struggle to meet targets for diabetes in the new contract and the national service framework as a study shows many practices are not conducting basic monitoring. Less than half of diabetes patients have had their...

Pay battle faces GPs in diabetes screening pilots.
March 10, 2003... GPs piloting a national screening programme for diabetes and vascular disease may be forced to `scrabble for cash' after the Government failed to ring-fence money for individual practices involved in the scheme. Pilots of systematic...

GP complacency a factor in missed flu vaccine target.(Brief Article)
March 10, 2003... GP complacency over the threat of flu may have been a factor in the failure to hit the national flu vaccination uptake target of 70 per cent, according to the Public Health Laboratory Service. Pulse has also learned GPs in Sheffield failed...

Hib backed for premature babies.(Hib vaccination)(Brief Article)
March 10, 2003... Hib vaccination is effective in premature babies despite their lower immune response, new research suggests. Despite vaccination, premature infants had a relative risk of developing the disease of 1.5 but this was not statistically...

Apologising for errors will cut patients' complaints.
March 10, 2003... GPs will cut the risk of potential disciplinary action by patients if they apologise immediately after making a mistake, according to the National Patient Safety Agency and NHS Confederation. The two organisations made the recommendation...

TALKING POINTS.
March 10, 2003... Dr Gavin Brydone has been a GP for 30 years. He practises in Edinburgh. Jo Carlowe spoke to him about the current hot topics in his practice. New contract Give me five words to sum up the new contract. A rather smelly curate's...

`Don't slice time off GP training'.(Brief Article)
March 10, 2003... The BMA has warned the Government not to slash the length of GP training as a means of tackling the recruitment crisis. The caution came after the Department of Health announced plans to streamline doctor training in its document Unfinished...

How a GP Mastermind promoted NHS career.(National Health Service)(Brief Article)
March 10, 2003... Dr Maggie Eisner took her seat in the famous Mastermind chair last week to help promote NHS careers to GCSE and A-level students. She answered two questions in five minutes from the Bradford students on what she enjoyed most and least in her...